I
% Judge Rules for Patients in Medicare Lawsuit Medicare Resource Center
visibility
315 views
thumb_up
11 likes
S
(Officials at the Centers for Medicare and Medicaid Services have suspended that three-day rule .) But sometimes, Medicare patients who go into the hospital and think they have been admitted as inpatients are instead changed to what Medicare calls observation status, meaning they are considered outpatients even if they remain in the hospital for days. "Unfortunately, the financial impact for Medicare beneficiaries who spend time in observation can be burdensome and significant." Outpatients can lose out two ways.
thumb_up
37 likes
H
In the hospital, they are subject to Medicare Part B rules for outpatients and so are responsible for 20 percent of the bills for their hospital care. That 20 percent can be more than they would pay if they were admitted as a regular patient and classified under Medicare Part A, which covers inpatient hospital services.
thumb_up
12 likes
A
And when they move from the hospital to a skilled nursing facility, they and so have to pay out of pocket. The difference in charges can amount to thousands of dollars.
thumb_up
11 likes
M
And though Medicare allows enrollees to appeal if they are denied many services or charged for things they don't believe they should be, Medicare has not allowed patients to appeal their status in a hospital, saying such decisions are for doctors to make based on their medical judgment. Nearly a decade ago, a group of Medicare beneficiaries sued the U.S. Department of Health and Human Services in what became a nationwide class action.
thumb_up
48 likes
N
Last week, in a ruling in that suit, U.S. District Judge Michael Shea of Connecticut said patients can appeal their hospital status if their doctor admitted them as a regular inpatient but the hospital later classified them as under observation.
thumb_up
1 likes
S
The U.S. Justice Department has until May 25 to appeal the decision.
thumb_up
40 likes
D
Shea's decision applies to all traditional Medicare beneficiaries whose status was switched since Jan. 1, 2009, who spent at least three days in the hospital and who were enrolled in Medicare's Part A hospital benefit.
thumb_up
20 likes
A
If they win their appeal, most hospital expenses and any nursing home bills they paid will be reimbursed, as long as they satisfied any deductibles and copays. "The ruling acknowledges that Medicare patients are in a very vulnerable position when they are hospitalized and particularly when they require care at a skilled nursing facility after hospitalization,” said Alice Bers, litigation director for the Center for Medicare Advocacy, which serves as lead counsel for the class.
thumb_up
20 likes
A
Congress passed a law in 2019 that requires hospitals to tell patients what status they are being treated under, but advocates say more is needed. Bills introduced in the U.S. House of Representatives and Senate would allow the time patients spend in the hospital under observation status to be counted toward the three-day hospital stay Medicare requires before it will pay for care in a skilled nursing facility.
thumb_up
27 likes
C
Those bills have languished in Congress so far. AARP has strongly supported the measures.
thumb_up
38 likes
C
“Unfortunately, the financial impact for Medicare beneficiaries who spend time in observation can be burdensome and significant,” David Certner, AARP's legislative counsel and legislative policy director, said in letters of support to the authors of the measures.
More on Medicare
Cancel You are leaving AARP.org and going to the website of our trusted provider.
thumb_up
6 likes
L
The provider’s terms, conditions and policies apply. Please return to AARP.org to learn more about other benefits. Your email address is now confirmed.
thumb_up
14 likes
J
You'll start receiving the latest news, benefits, events, and programs related to AARP's mission to empower people to choose how they live as they age. You can also by updating your account at anytime.
thumb_up
44 likes
E
You will be asked to register or log in. Cancel Offer Details Disclosures
Close In the next 24 hours, you will receive an email to confirm your subscription to receive emails related to AARP volunteering.
thumb_up
35 likes
S
Once you confirm that subscription, you will regularly receive communications related to AARP volunteering. In the meantime, please feel free to search for ways to make a difference in your community at Javascript must be enabled to use this site.
thumb_up
26 likes
V
Please enable Javascript in your browser and try again.
thumb_up
31 likes
Similar Discussions
-
Family or Fiancé Season 3 Episode 4 Fans shower support for Jackie as she opens up about being a victim of abuse
-
WWE legend recognizes Tony Khan s efforts in bringing back top AEW star
-
Korean Language Spacing Puzzle APK Download for Android
-
Defensive MVPs Players of the Week in all 15 girls soccer conferences Oct 20 Hs Stats Hs Tweet
-
At least 15 killed in bus truck collision on Indian highway India 15 People
-
I Make Various Felt Animal And Fantasy Character Sculptures
-
The Case for a Giant E Book Reader
-
How to Resize a Mac Volume With Disk Utility
-
Compare Kia Telluride vs Subaru Tribeca CarBuzz
-
Compare Polestar 2 vs Volvo S60 CarBuzz
-
Compare Audi Q7 vs Audi Q8 CarBuzz
-
We Wish A Happy 45th Birthday To The Volkswagen Golf CarBuzz
-
Volvo Wants To Make Clear That You Are Still The Driver CarBuzz
-
What is a brain tumor? A Mayo Clinic expert explains Mayo Clinic
-
How to Improve Your Flexibility Everyday Health
-
What is a rainbow baby and why are they special
-
There s been a lot of uncertainty in this building for the last couple of years Kyrie Irving shares his views on Kevin Durant demanding a trade from the Brooklyn Nets in the offseason
-
Multi time WWE Champion John Cena references AEW Dynamite segment roasting Vince McMahon
-
Elden Ring Subreddit Desperately Trying To Keep It Together For Launch Day
-
Tip Remember the Little Orange Capsule
-
Tip The Push Pull Pyramid
-
What Happened to As the World Turns Star Marnie Schulenburg?
-
Announcing the agenda for TechCrunch Sessions Crypto 2022 • TechCrunch Ripene
-
Naughty Dog Teases Upcoming The Last Of Us Announcement
-
How much of each skincare product to apply YOU Magazine
-
10 numara tahmin programı
-
Bilinçli tüketici ile ilgili bilgiler
-
Fatih murat arsal pdf
-
Kral tv top 20 haziran
-
When To Change Credit Cards If Your Business Is Growing